فهرست مطالب ravi kant

It is pertinent to objectively assess the severity of diabetic gastroparesis and tailor treatment accordingly. The current study was planned to document gastroparesis by gastric emptying scintigraphy (GES) objectively and see the effect of medications and diet control on clinical and GES after four weeks.

A prospective, open-label randomized trial was conducted in the Department of Internal Medicine at a tertiary care teaching hospital over twelve months. Type 2 diabetic patients aged 18-65 years diagnosed with a case of delayed gastric emptying by gastric scintigraphy were included. All baseline GSCI was recorded, and then they were allotted to 3 groups – Group-1 (Levosulpiride 25mg once daily), group-2 (Cinitapride 1mg thrice daily), and Group-3 (Waitlisted control) by block randomization and followed-up weekly till four weeks. After four weeks duration, if not improved clinically, then Group-3 on diet and diabetic control only, were randomized into Levosulpiride 25mg once daily (Group 1), and Cinitapride 1mg Thrice daily (Group 2) for the next four weeks.

Forty confirmed cases with diabetic gastroparesis documented by Gastroparesis Symptom Cardinal Index (GCSI) scoring and later by Scintigraphy (GES) were included in this study. However, there was no statistically significant difference between the Levosulpiride and Cinitapride groups when all symptoms were taken into account. Levosulpiride was significantly more effective than Cinitapride in improving individual symptoms like nausea, vomiting, stomach fullness, and early satiety.

Levosulpiride is better than Cinitapride in improving the symptoms of diabetic gastroparesis but no significant effect on gastric scintigraphy.

Hypoglycemia is frequently associated with insulin therapy in diabetic patients; it leads to many short and long-term complications and even death if not addressed in time. This study was undertaken to observe the circadian propensity of hypoglycemia and its recovery time based on type 2 diabetes mellitus patients’ clinical parameters.

We included type 2 diabetes mellitus (DM) hospitalized patients with the exclusion of patients suffering from critical illness. Data were collected for a period of three months (September to November 2019).

A total of 120 patients were included, comprising 60% males and 40% females. Approximately 55% of patients had hypoglycemic episodes at around 12 am– 6 am. The most common comorbidity present in these patients was hypertension (43.3%, P=0.931). Anemia (OR-3.765, CI-1.350-5.500, P=0.011), retinopathy (OR 6.066, CI-2.031-8.113, P=0.001), and duration of DM (OR-6.266, CI-2.209-7.774, P=0.001) were significantly associated with the recovery time of hypoglycemia, around 50±14.14min in the elderly population of age 60-70. People with BMI 22.5- 27.5 Kg/m2 took around 45.66 ± 19.37 min to recover after treatment.

Time taken to recover from hypoglycemic episodes vary with age and BMI. Associated comorbidities such as anemia, retinopathy, and DM duration had a significant bearing on the time taken to recover from hypoglycemia. Recovery time was directly proportional to BMI, a new finding that needs further molecular level evaluation. Circadian propensity of hypoglycemia in these patients have been identified in the early morning hours of the day.

Coronavirus disease rapidly spreads across the entire world in < 2 months and gravely jeopardizes the regular human routine. The medical fraternity recommends a vaccine as one of the best solutions to save the universe. However, to be effective, the population should reflect an encouraging attitude to accept it. The study aimed to measure vaccine acceptability and reason for hesitancy among the public.

Eight hundred and forty one adults visiting a tertiary care hospital responded to a pretested validated questionnaire on vaccine acceptability and hesitancy. The Chi‑square test and independent t‑test, followed by multinomial logistic regression, were used to analyze the findings.

Overall, 53.4% (n = 445) of participants interested to take vaccine, 27.2% (n = 229) were not sure, and the remaining 19.4% (n = 163) did not intent to vaccinate. Gender (P = 0.013), information on the vaccine (P = 0.022), chances to get coronavirus disease in the next 6 months (P < 0.001), awareness on India COVID‑19 vaccine (P < 0.001), Indian manufacturing company of vaccine (P < 0.001), family history of the laboratory‑confirmed case (P < 0.001), and health status (P = 0.011) found a significant association with intention to vaccination (a response “yes” vs. “no” and “not sure”). Reasons for vaccine hesitancy included specific antivaccine attitudes and beliefs, a concern of fear and phobia, lack of information, and safety issues on the vaccine.

This institute‑specific survey revealed that approximately every 4 in 8 people were not sure to take the vaccine, and one in five people refused to be vaccinated. The study recommends using target‑based health education to understand and address vaccine‑specific concerns to enhance vaccine coverage, and boost confidence among the population.

Type 2 diabetes mellitus (DM) is a multifactorial disease and can be described as a noncommunicable disease of epidemic magnitude. Little is known about the predictors of depression in this population, especially among the Indian population. This study explores the predictors for depression in patients with type 2 DM.

A cross‑sectional study was performed for a period of 7 months during 2018–2019. The data were collected from 250 subjects at the diabetic clinic and psychiatry outpatient department of a tertiary care teaching hospital. T2DM with an age group of 18–60 years were included. Exclusion criteria were clinical evidence of any significant Axis I psychiatric disorder according to the International Classification of Diseases‑10 Diagnostic Criteria for Research other than depression and substance use disorders. Data were analyzed with multiple linear regression analysis using SPSS‑23 version.

Male and female patients were 127 (50.80%) and 123 (49.20%), respectively. The prevalence of depression was 49.20% among 250 patients with T2DM. Female patients had higher depression than male patients. We found age (P = 0.013), female gender (P = 0.041), locality of the patient (P = 0.021), body mass index (BMI) (P = 0.018), and fasting blood sugar (FBS) (P = 0.045) as significant predictors of depression among T2DM patients.

The study concludes that females and elderly patients were more affected by depression. The predictors of depression were age, gender, locality, BMI, and FBS among diabetic patients. The findings indicate to screen the patients of T2DM for depression, predominantly female and elderly patients, at regular intervals as per clinical demand.

COVID‑19 was declared an emergency of international concern by the World Health Organization in 2020. This study assesses patients’ awareness, perception, and mitigating measures taken during the COVID‑19 outbreak visiting an apex tertiary health‑care center in North India.

A cross‑sectional study was conducted between September 15, 2020, and November 15, 2020, in a tertiary care public hospital, North India, using a structured self‑administered questionnaire. The survey included 809 patients using a consecutive sampling strategy. The self‑structured and prevalidated questionnaire was used to collect information on study variables. Chi‑square test and independent samples t‑test, followed by binary and multivariate logistic regression, was used to determine the factors associated with awareness toward COVID‑19.

The mean age of participants was 32.41 (±11.24) years. Multivariate logistic regression shows that married participants (OR: 0.660, 95 % CI: 0.440-0.989, P= 0.044), reading books/ magazine or attended institutional lectures (OR: 2.241, 95% CI: 1.545–3.249, P = 0.001), and watching television and radio (OR: 1.824, 95% CI: 1.283–2.592, P = 0.001) are significantly more aware than their counterparts. Participants with higher income group (>20,000 Indian rupee) significantly had higher awareness than participants having salary <10,000 rupees (OR: 0.280, 95% CI: 0.178–0.440, P = 0.001) or 10,001–20,000 rupees (OR: 0.481, 95% CI: 0.297–0.777, P = 0.003). Patients avoiding traveling across or abroad had significantly much reasonably good awareness than their counterparts (OR: 0.357, 95% CI: 0.139–0.918, P = 0.033).

Participants demonstrated good awareness, encouraging perception, and complied with appropriate mitigating measures during the outbreak. Considering frequent waves and the pandemic’s long duration, consistent reinforcement of government measures, including masks, maintaining social distance, and frequent handwashing, is much needed.

A stereoselective high performance liquid chromatographic analytical method with photodiode array detector was developed and validated as per the International Conference on Harmonization (ICH) guidelines for the determination of alogliptin (ALO) enantiomers in formulations and rat plasma. Enantiomeric separation was performed on a Phenomenex Lux Cellulose-2 chiral column. Box-Behnken design was used to identify the optimum conditions of the three independent variables for the desired output responses. The HPLC peaks of ALO enantiomers and the internal standard pioglitazone were achieved before 8 min with a resolution of 0.77 min between R and S enantiomer and resolution of more than 2.0 between each enantiomer and pioglitazone (internal) with more than 95% recovery. The linearity range and the limit of quantification of both the enantiomers in rat plasma were 10-70 ng mL-1 and 1.2 ng mL-1 respectively. The developed method after validation was successfully applied for estimation of ALO enantiomers in formulations. Single oral dose of 25 mg of the ALO racemate tablets were administered to a group of 6 healthy rats for a comparative pharmacokinetic study of both the enantiomers.